Pediatric COVID-19 extracorporeal membrane oxygenation transport during the pandemic. in Perfusion / Perfusion. 2024 Sep;39(6):1113-1119. doi: 10.1177/02676591231176243. Epub 2023 May 12.

2024
ASL Città di Torino

Tipo pubblicazione

Journal Article

Autori/Collaboratori (13)Vedi tutti...

De Piero ME
ECMO Transport Team, Hospital 12 de Octubre, Madrid, Spain.
Amigoni A
Pediatric Critical Care Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain. RINGGOLD: 16810
Balcells J
ECMO Transport Team, Hospital 12 de Octubre, Madrid, Spain.

et alii...

Abstract

INTRODUCTION: ExtraCorporeal Membrane Oxygenation (ECMO) in pediatric patients with COVID-19 has a survival rate similar to adults. Occasionally, patients may need to be cannulated by an ECMO team in a referring hospital and transported to an ECMO center. The ECMO transport of a COVID-19 patient has additional risks than normal pediatric ECMO transport for the possible COVID-19 transmissibility to the ECMO team and the reduction of the ECMO team performance due to the need of wearing full personal protective equipment. Since pediatric data on ECMO transport of COVID-19 patients are lacking, we explored the outcomes of the pediatric COVID-19 ECMO transports collected in the EuroECMO COVID_Neo/Ped Survey. METHODS: We reported five European consecutive ECMO transports of COVID-19 pediatric patients collected in the EuroECMO COVID_Neo/Ped Survey including 52 European neonatal and/or pediatric ECMO centers and endorsed by the EuroELSO from March 2020 till September 2021. RESULTS: The ECMO transports were performed for two indications, pediatric ARDS and myocarditis associated to the multisystem inflammatory syndrome related to COVID-19. Cannulation strategies differed among patients according to the age of the patients, transport distance varied between 8 and 390 km with a total transport duration between 5 to 15 h. In all five cases, the ECMO transports were successfully performed without major adverse events. One patient reported a harlequin syndrome and another patient a cannula displacement both without major clinical consequences. Hospital survival was 60% with one patient reporting neurological sequelae. No ECMO team member developed COVID-19 symptoms after the transport. CONCLUSION: Five transports of pediatric patients with COVID-19 supported with ECMO were reported in the EuroECMO COVID_Neo/Ped Survey. All transports were performed by an experienced multidisciplinary ECMO team and were feasible and safe for both the patient and the ECMO team. Further experiences are needed to better characterize these transports and draw insightful conclusions.

Accesso banca dati bibliografica

PMID : 37173806

DOI : 10.1177/02676591231176243

Keywords

extracorporeal membrane oxygenation; SARS-CoV-2; Europe; COVID-19; Infant, Newborn; Systemic Inflammatory Response Syndrome/therapy; Myocarditis/therapy; Transportation of Patients/methods; Respiratory Distress Syndrome/therapy; Pandemics; Adolescent; SARS-CoV-2; Child, Preschool; Infant; Female; Male; Child; COVID-19/therapy/complications; Extracorporeal Membrane Oxygenation/methods; Humans; pediatric intensive care unit; respiratory failure;